摘要
目的总结急诊同指近节背侧岛状皮瓣修复手指末节脱套伤的手术方法及临床疗效。方法选择2011年11月至2017年8月唐山市第二医院手外科应用同指近节背侧岛状皮瓣技术修复治疗的手指末节脱套伤患者21例(21指)为研究对象,按照皮肤缺损面积设计皮瓣大小,以一侧指间动脉为蒂,旋转180°逆行修复手指末节脱套伤,可同时携带双侧指背神经,并与指端双侧指掌侧固有神经相吻合,供区行全厚皮片游离植皮修复。结果采用近节背侧岛状皮瓣修复手指末节脱套伤21例21指皮瓣及手指均良好存活,供区创面一期愈合。术后随访6个月至1年,损伤手指感觉及功能恢复良好,皮瓣外观及质地良好,患者对皮瓣及伤指外观满意。后期随访指端皮瓣两点辨别觉4~6 mm,平均(3.0±1.5)mm。结论应用近节背侧岛状皮瓣修复手指末节脱套伤,能够恢复手指良好的外观、感觉及功能,是解决此类手指损伤的一种良好方法。
Objective To summarize the surgical methods and clinical effects of proximal dorsal island flap for the repair of degloving injury of distal phalanx in emergency.Methods From Nov.2011 to Aug.2017 in the Department of Hand Surgery of Tanshan Second Hospital,21 cases of degloving injury of distal phalanx were treated with proximal dorsal island flap,and these cases were included in the study.According to the area of skin defectthe flap size was designed,with one interphalangeal artery as pedicle,180°was rotated for retrograde repairing of finger tip degloving injury,which can carry bilateral dorsal nerve,realize anastomosis with intrinsic nerves of bilateral palmar finger,and free skin graft repair of full thickness skin was performed in the donor area.Results All of the 21 cases of finger skin flaps and fingers all well survived by using proximal dorsal island flap,and the donor areas were primarily healed.During the follow-up period of 6 months to 1 year,the finger sensation and function recovered well,the skin flap had a good appearance and texture,and the patients were satisfied with the skin flaps and injured fingers.At the end of the follow-up,the two-point discrimination of the fingertip were 4-6 mm,with an average of(3.0±1.5)mm.Conclusion The proximal dorsal island flap in repairing the degloving injury of distal phalanx has advantages of good recovery of the finger appearance,sensation and function,therefore is a good method to treat such finger injuries.
作者
李志刚
曾祥悦
张会文
李瑞国
赵少平
李军
魏威
LI Zhigang;ZENG Xiangyue;ZHANG Huiwen;LI Ruiguo;ZHAO Shaoping;LI Jun;WEI Wei(Department of Hand Surgery,Tangshan Second Hosipital,Tangshan 063000,China;Department of Clinical Medicine,Hebei Tangshan Institute of Technology,Tangshan 063000,China;Department of Orthopedics,Tangshan People′s Hosipital,Tangshan 063000,China)
出处
《医学综述》
2018年第7期1453-1456,共4页
Medical Recapitulate
基金
河北省科技计划研究课题(20170777)
关键词
脱套伤
皮瓣
末节脱套伤
Degloving injury
Flap
Degloving injury of distal phalanx
